This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Monday, September 02, 2013

Weekly Australian Health IT Links – 2nd September, 2013.

Here are a few I have come across the last week or so.

Note: Each link is followed by a title and a few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.

General Comment

Before we get to the serious stuff the rumour mill grinding away and is asking - just who is the senior executive in the e-Health domain who loves flying business class and who, as times look to be changing in Canberra, has sold out, jumped ship and migrated far, far north, somewhat leaving his colleagues in the lurch, to take a well-paid international job as e-Health unravels in OZ! The very same executive apparently seems to have left a lot of e-Health Standards processes in a mess and made some long term Standards Australia volunteers just give up. Comments and insights welcome.

The serious stuff is, of course, the election we are all participating in on Saturday, to decide, among other things, who will be the Health Minister and who will be directing e-health in OZ for the next few years.

On the basis of the reports it seems neither of the major parties is seen as having a greatdeal to offer for clinicians and that neither are all that popular or offering much that will make a difference. As many others are saying all I can do is with you luck in making a choice - it is just way too hard for me!

THE man in line to possibly become Australia’s next health minister has accused Tanya Plibersek of having “barely contained contempt for doctors” and pledged to rebuild the eroded standing of general practice.

In an interview with Medical Observer, shadow health minister Peter Dutton said Labor and the health minister had treated the nation’s doctors with “suspicion” rather than respect.

He also argued that the super clinic program, along with moves to cap tax-deductible self-education expenses, had undermined general practice and created further disincentives for graduates to choose the specialty.

At the National Press Club today, Health Minister Tanya Plibersek and Opposition Health Spokesman Peter Dutton laid out key health policy priorities for each party in the lead-up to the Federal Government.

Aside from Peter Dutton’s introductory address, eHealth did not feature prominently in the debate, nor was it highlighted in journalists’ questions.

Minister Plibersek focused on Labor’s track record as well as personal highlights during her almost two years in office including the introduction of the $4.1 billion Grow Up Smiling program for children’s dental care, the flexibility of funding through Medicare locals to fill gaps , and the introduction of $6 billion worth of new medicines since 2007.

TONY Abbott's backflip on coalition plans to close Medicare Locals is not "credible", Federal Health Minister Tanya Plibersek says, accusing the opposition of having four different positions on Labor's health network.

Mr Abbott declared "we are not shutting any Medicare Locals" during a leaders debate on Wednesday, despite previously pledging a detailed review of the primary health care providers, and despite refusing to rule out closures earlier in the campaign.

"They first said they were going to get rid of them, then they said they were going to review them, then they said they couldn't rule out closing, and last night they said they could rule out closing," Ms Plibersek told ABC TV on Thursday.

TONY Abbott has vowed to work with health professionals to review the troubled $700 million personally controlled e-health record system should the Coalition win on September 7.

One GP called for the PCEHR to be governed by an independent council comprising medical experts. The proposed review does not come as a surprise as the opposition called for a "pause" to the system's rollout more than two years ago.

Both Queensland Liberal senator Sue Boyce and opposition e-health spokesman Andrew Southcott have repeatedly criticised the PCEHR implementation over the years.

While the future of the National E-health Transition Authority - Mr Abbott's baby while he was health minister during the Howard years - under a Coalition government is uncertain, doctors say an e-health overhaul is timely. The opposition's health policy, released last week, says "if elected, the Coalition will undertake a comprehensive assessment of the true status of the PCEHR implementation".

The Consumers e-Health Alliance is calling on the major parties to revisit the $1 billion national electronic medical information-sharing system and actually deliver the promised benefits.

CeHA convenor Peter Brown says the launch of the $1 billion Personally Controlled Electronic Health Record (PCEHR) “needs to be seen positively for the opportunities it presents.”

But with emerging difficulties identified by medicos, consumers, the local health IT industry and the full range of State and Federal government agencies charged with implementation, CeHA believes it is now important to bring all parties together to tackle the issues.

CONCERN over the departure of a number of NEHTA’s clinical experts, including national clinical lead Dr Mukesh Haikerwal, has prompted calls for an independent council to be given responsibility for the e-health records initiative.

A week after the resignations, NEHTA would not reveal details of how many clinical leads it would retain or seek to recruit following the mass departure.

It said it recognised the importance of clinical input into e-health and the PCEHR and that along with the Department of Health and Ageing, it had “a range of governance arrangements in place to obtain clinical input”.

As global rates of diabetes escalate, a new study suggests that internet technologies may be helping to overcoming the impact on the Australian healthcare system.

The Monash University study, published in the Medical Journal of Australia, monitored 577 diabetes patients over 14 months. It showed significant improvements in quality of care and clinical outcomes for patients whose care was supported by internet-based care management service, cdmNet.

The study was led by Professor Grant Russell, Head of the School of Primary Healthcare, and director of the Southern Academic Primary Care Research Unit (SAPCRU) at Monash as well as Professor Peter Schattner of the Department of General Practice.

Pharmacists will be able to claim up to $2000 per pharmacy if they use electronic prescription scanning systems, as part of a new incentive announced today.

The decision to incentivise the use of Electronic Transfer of Prescriptions (ETP), comes after months of negotiations between the Pharmacy Guild of Australia and the Department of Health and Ageing, and will be applicable for the 2013/14 financial year.

The new incentive, which uses existing Fifth Community Pharmacy Agreement funds, is aimed at driving ETP use in pharmacies to improve quality use of medicines and reducing the number of adverse medication events.

The first statewide integrated electronic health record in Australia is being rolled out this week.

The launch of SA Health’s Enterprise Patient Administration System (EPAS) at Noarlunga Hospital will mean its doctors and nurses can electronically access patient information at the bedside and throughout the hospital.

State Health Minister Jack Snelling said EPAS would support staff in providing safe, efficient care to patients.

For the first time, clinicians will be able to access medical records electronically and order tests, medication and review results from computers at their patient’s bedside and other points of care around the hospital, Snelling said.

An institution has a health record eco-system that is distributed and poorly connected. Due to technical, procedural and policy issues, the data is divided into a series of different silos, and there’s not a lot of inter-connection between them. Though – presumably – the systems have connection points through the patient clinical process, because of differences in perspective and purpose, different information is collected, and because of various system design approaches and various lapses in system continuity (the fog of war), the data is a little out of sync.

Telstra has acquired e-health software company Database Consultants Australia in the telco’s first standalone health acquisition.

The acquisition follows several other e-health investments from Telstra, which is looking to build up its health portfolio as part of a strategy to develop new growth businesses.

“Connectivity will play a crucial role in the future delivery and management of health services. The future of health care will see more patients cared for at home and technology will play a critical role,” Shane Solomon, Telstra’s head of health, said in a statement.

Ensuring Clinical Utility and Function in a Large Scale National Project in Australia byEmbedding Clinical Informatics into Design

Across the globe, healthcare delivery is being transformed by electronic sharing of health information. Such large scale health projects with a national focus are a challenge to design and implement. Delivering clinical outcomes in the context of policy, technical, and design environments represents a particular challenge. On July 1, 2012, Australia delivered the first stage of a personally controlled electronic health record -- a national program for sharing a variety of health information between health professionals and between health professionals and consumers. As build of the system commenced, deficiencies of the traditional stakeholder consultation model were identified and replaced by a more structured approach, called clinical functional assurance.Utilising clinical scenarios linked to detailed design requirements, a team of clinicians certified clinical utility atimplementation and release points.

The draft Australian Privacy Principle (APP) guidelines have been released for public feedback by the Office of the Australian Information Commissioner (OAIC).

Australian Information Commissioner Professor John McMillan said the guidelines outline how the OAIC will interpret and apply the APPs which come into law on 12 March 2014.

The draft guidelines will be released in stages during September. The first stage includes new requirements for agencies and enterprises about how they manage personal information, including the requirement to have a clearly expressed and up-to-date privacy policy.

THERE is a digital divide in this nation and it has nothing to do with the National Broadband Network and its rollout, or lack thereof.

It has to do with who has and who does not have home access to the internet. This question has been asked at the past two censuses so it's possible to see where the digital divide lies. And as far as I can see access to the internet in the home is seeping out from the knowledge workers of the inner city to embrace the ordinary and the aspirational of middle Australia on the very edges of the city.

Between the 2006 and 2011 censuses, there was a 16 percentage point lift in the proportion of households with access to the internet. The type of access - broadband, dial-up, wireless - is not relevant to the existence and the course of the digital divide. Rather, the question is whether some parts of metropolitan Australia are being left behind in the digital revolution. At the 2011 census, 79 per cent of households had internet access; based on recent growth rates this proportion now is probably closer to 85 per cent, although there are some parts of the nation where the rate of household internet access exceeds 90 per cent.

A “HUGE amount of public benefit” has been lost in the past 30 years because of restricted access to health data fuelled by privacy concerns, says a leading Australian researcher.

Professor John Mathews, retiring executive director of the Menzies Foundation and professorial fellow at the University of Melbourne, said anxiety generated by HIV and AIDS in the 1980s coincided with the digital revolution, resulting in heightened concerns about privacy and a decline in access to health data for research purposes.

However, he said, the thinking had now “matured” and many members of the public were surprised that data collected at public expense was not being routinely used for public benefit.

Professor Mathews was commenting on US research, published in JAMA Internal Medicine, which found patients cared most about the purpose for using their health data, and less about the user of the information and the sensitivity of the information. (1)

The Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM) have collaborated to develop a new online education activity that provides information and resources on the integration of a range of e-health technologies within general practice.

The Making e-health work for your general practice online learning module is created for general practitioners (GPs) and general practice registrars to assist the understanding of the key role e-health plays in healthcare delivery.

The learning activity is available from today and aims to assist GPs in adopting appropriate e-health systems to their practice setting, build e-health awareness, help GPs understand the principles and benefits of a national eHealth record system (also referred to as the Personally Controlled eHealth Record System) and simplify the implementation of e-health tools in general practice.

The beauty of MyFitnessPal is its extensive food database, which includes a surprisingly wide selection of Aussie brands. This takes much of the guesswork out of calorie counting (or kilojoules, if you prefer), so it really just comes down to how conscientious you are about logging food and keeping to your daily calorie limit. You can also use MyFitnessPal with dozens of apps and devices such as Runkeeper, Fitbit, and Withings Wi-Fi scales.

Michele Munz

Missouri S&T researchers are using small, porous glass scaffolds like these to regenerate bone.

Sometimes medical advances don't come from the medical field at all.

Engineers at the Missouri University of Science and Technology have designed a super-strong glass implant with a scaffolding-like structure that is able to grow new bone.

"We have good material and engineering skills," said lead researcher Len Rahaman, "and when you put those two together, it's allowed us to use our skills to produce a bioactive glass that is strong enough to repair large structural bone defects."

Tony Brown

It would take a crazy politician to tear down a hugely popular project that was on time and budget, says Tony Brown.

Last week in The Sydney Morning Herald, Opposition communications spokesman Malcolm Turnbull called for voters to elect a Coalition government in the looming election - no surprise there - but in reading the piece I had one of those 'what if' moments.

“In December 2010…Labor released the NBN Co corporate plan. It stated that by June 2013, more than 1.7 million households and businesses would be able to connect to the NBN – and its fibre optic network would have 511,000 users,” Turnbull wrote.

As we know the critical fiber-to-the-premises (FTTP) portion of the NBN has in fact only passed around 200,000 homes – with about 25 per cent of these not actually able to connect to services – and has only 33,000 subscribers.